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泌尿外科中使用决策辅助工具、宣传册、视频及新技术的全面同意:增强患者选择权与共同决策。

Comprehensive consent in urology using decision aids, leaflets, videos and newer technologies: empowering patient choice and shared decision-making.

作者信息

Nedbal Carlotta, Naik Nithesh, Davis Niall, Madaan Sanjeev, Tokas Theodoros, Cacciamani Giovanni, Ventimiglia Eugenio, Geraghty Robert M, Enikeev Dmitry, Somani Bhaskar K

机构信息

Urology Unit, ASST Fatebenefratelli Sacco, Milan, ITA; Endourology Section, European Association of Urology, Arnhem, The Netherlands.

Department of Mechanical and Industrial Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Ther Adv Urol. 2024 Nov 23;16:17562872241301729. doi: 10.1177/17562872241301729. eCollection 2024 Jan-Dec.

Abstract

In this paper, we explore the usage of decision aids, patient information leaflets (PILs), videos, social media and modern technology to empower patients and enable shared decision-making (SDM). It explores the role of enhanced consent processes in urology. A re-evaluation of the conventional consent process is required towards more patient-centred care and SDM, which prioritises patient education and understanding of their medical conditions and treatment pathways. The use of decision aids, such as multimedia resources and PILs, is crucial in enhancing patients' understanding, level of satisfaction, quality of life and healthcare utilisation. New tools are opening exciting possibilities for patient education and information distribution, such as Chat Generative Pre-Trained Transformer (ChatGPT). The effectiveness of ChatGPT in comparison to well-established PILs is still up for debate, despite the fact that it makes information easily accessible. Improving patients' involvement, understanding and engagement in SDM procedures relies heavily on decision aids, PILs and current technological integration. Patients and healthcare practitioners should work together in accordance with the principles of SDM, which include considering patients' values, backgrounds, priorities and preferences when making treatment decisions. The emphasis on patient-centred care has prompted a re-evaluation of traditional consent processes in urology, with more emphasis on the shared decision-making process. Several informative aids are currently available as reported in the literature, ranging from 3D models, multimedia presentations and virtual reality (VR) devices. While the costs of these tools might be substantial, the advantages of adopting such informative resources are unmistakable. Social media and platforms such as patient-physician blogs are increasingly popular sources of medical information. Urologists should embrace these platforms to enhance patient engagement and the quality of information provided. Despite recent progress, there remains significant room for improvement in patient education and engagement which is achievable via concerted efforts of a wider medical community.

摘要

在本文中,我们探讨了决策辅助工具、患者信息手册(PILs)、视频、社交媒体和现代技术的使用,以增强患者能力并实现共同决策(SDM)。本文探讨了强化同意程序在泌尿外科中的作用。需要对传统同意程序进行重新评估,以实现更以患者为中心的护理和共同决策,其优先考虑患者教育以及对自身病情和治疗途径的理解。使用决策辅助工具,如多媒体资源和患者信息手册,对于提高患者的理解、满意度、生活质量和医疗保健利用率至关重要。新工具为患者教育和信息传播带来了令人兴奋的可能性,例如聊天生成预训练变换器(ChatGPT)。尽管ChatGPT能使信息易于获取,但与成熟的患者信息手册相比,其有效性仍有待讨论。提高患者在共同决策程序中的参与度、理解和参与程度在很大程度上依赖于决策辅助工具、患者信息手册和当前的技术整合。患者和医疗从业者应根据共同决策的原则共同努力,这些原则包括在做出治疗决策时考虑患者的价值观、背景、优先事项和偏好。对以患者为中心的护理的强调促使对泌尿外科传统同意程序进行重新评估,更加注重共同决策过程。如文献报道,目前有几种信息辅助工具,包括3D模型、多媒体演示和虚拟现实(VR)设备。虽然这些工具的成本可能很高,但采用此类信息资源的优势是显而易见的。社交媒体以及患者 - 医生博客等平台越来越成为受欢迎的医疗信息来源。泌尿外科医生应利用这些平台来提高患者参与度和所提供信息的质量。尽管最近取得了进展,但通过更广泛的医疗界的共同努力,患者教育和参与仍有很大的改进空间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06ff/11585043/c4ae5a2c8efa/10.1177_17562872241301729-fig1.jpg

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